ORIGINAL RESEARCH article
Front. Ophthalmol.
Sec. Neuro-Ophthalmology Disorders
Exploring the Impact of Age of Onset on Stereoacuity in Patients with Myasthenia Gravis
Provisionally accepted
- 1National Yang Ming Chiao Tung University (Yangming Campus), Taipei, Taiwan
- 2Taipei Medical University Shuang Ho Hospital Department of Neurology, New Taipei, Taiwan
- 3Shin Kong Wu Ho Su Memorial Hospital, Taipei City, Taiwan
- 4Fu Jen Catholic University, New Taipei, Taiwan
- 5Kaohsiung Medical University, Kaohsiung, Taiwan
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Abstract Myasthenia gravis is an autoimmune disorder that can result in fluctuating muscle strength and various ocular manifestations. Common ocular signs and symptoms in MG patients include ptosis, limited eye movement, and diplopia. Purpose This study aimed to investigate the association between clinical characteristics of MG, specifically the age of onset, and stereoacuity in MG patients. Design This is a cross-sectional study that enrolled 150 MG patients. Methods Stereoacuity were assessed using the Butterfly Stereo Acuity Test. Main analysis was conducted using multinomial logistic regression to explore the relative risk associated with different levels of stereoacuity. Results This study included 150 MG patients: 58 (38.7%) with normal stereoacuity, 80 (53.3%) with weak stereoacuity, and 12 (8%) unable to identify any stereo chart. Patients with MG onset before age 7 (n=15) had a significantly higher risk of being unable to identify any stereo any stereo chart (RRR=14.73; p=0.03). Among ocular manifestations, ptosis (RRR=2.33; p<0.05) and diplopia (RRR=2.26; p<0.05) were associated with weak stereoacuity, whereas EOM disorder was significantly associated with being unable to identify any stereo any stereo chart (RRR=10.57; p<0.01). Conclusion Findings suggest that an early onset of MG may contribute to impaired stereoacuity. For patients diagnosed with MG before age of 7, it is advisable to ensure optimal management of MG itself. Future studies should explore the potential long-term implications of early onset MG on binocular vision, ophthalmoplegia, and the impact of ocular signs and symptoms on patients' quality of life.
Keywords: Depth Perception, Diplopia, Extraocular movement, myasthenis gravis, Ptosis
Received: 10 Sep 2025; Accepted: 15 Dec 2025.
Copyright: © 2025 Cheng, Chiu, Hung and Yeh. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Jiann-Horng Yeh
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